CPP Disability medical report (ISP-2519)

Who may complete the medical report

• The treating physician or nurse practitioner who actually knows the file is the usual signatory.
• A specialist letter can be attached when the restriction lives in that specialty (cardiology, psychiatry, oncology, neurology).
• Do not sign a report for a patient you have not assessed, or from a chart you cannot defend.
• Allied health notes (PT, OT, psychology) are useful attachments. They do not replace the medical report unless Service Canada has asked for that document specifically.

If you took over care last month, say so. Certify what you can support. Do not invent a ten-year functional history from a problem list.

How to complete the clinical sections

Work backwards from occupation. What can this person do for a full workday, most days, in any job that exists in the economy? Then write the medical reasons. A diagnosis of fibromyalgia or major depression, without residual function, is a common reason the file stalls.

• Conditions and dates: when each relevant condition began, and when function collapsed to the current level. Those dates are not always the same.
• Investigations and treatment: current meds, doses, failed trials, surgery, rehab, and whether the person adheres. If they declined a reasonable treatment, say so without editorializing.
• Objective findings: exam, imaging, neuropsych, serial PHQ/GAD only if they change management. Do not paste the entire EMR.
• Functional work capacity: sitting, standing, lifting, walking, concentration, memory, pace, attendance, need for unscheduled breaks, and whether they can work reliably day after day.
• Prognosis: prolonged means long continued and of indefinite duration, or likely to result in death. A planned six-month recovery is usually not CPP-D.
• Other work: if they could do a different job with restrictions, write the restrictions honestly. Do not stretch the form to match the patient’s hope for approval.

Inconsistency kills files. If your last three notes say “improving, considering return to modified duties” and ISP-2519 says “no work of any kind,” Service Canada will notice. Align the report with the chart.

Worked example (fictional)

Conditions: ischaemic cardiomyopathy (NYHA III), HFrEF 28% post-STEMI 2023; recurrent major depression, currently moderate.
Work history: stopped all work April 2024 after a second admission for decompensated heart failure. Last job required 8–10 hour shifts, walking the floor, occasional 20 kg lifts.
Function most days: dyspnoea after one flight of stairs; sits 20–30 minutes then needs to lie down; cannot sustain concentration for a half-day of paperwork because of fatigue and slowed processing. Two unplanned ED visits in 6 months when diuretics were adjusted.
Treatment: ARNI, beta-blocker, MRA, SGLT2i, sertraline 100 mg, cardiac rehab completed. No further revascularization planned. Restriction is residual, not untreated.
Prognosis: already >12 months at this level; indefinite. Not a terminal-illness file.
I am the most responsible family physician since 2018. Cardiology consult of 2025-11-04 attached.

Why Service Canada comes back

• Writing that they cannot do their old job, and saying nothing about other work.
• Diagnosis without function, or function without dates.
• Optimistic chart notes that contradict a totally disabled report.
• Missing investigations for the condition that is supposed to be work-disabling.
• Using the terminal-illness form when life expectancy is not six months or less.
• Illegible handwriting, missing practitioner identifiers, or an unsigned page.

Frequently asked questions